Research

The Division of Neonatal–Perinatal Medicine is committed to improving neonatal care by engaging in clinical research. Our faculty have diverse research interests and are involved in national and global research. We work collaboratively with Duke Neonatal Perinatal Research Unit as a NICHD Neonatal Research Network (NRN) site and the Pediatric Trials Network (PTN). Some of the many studies that we are currently involved in are listed below.

Currently Enrolling

Generic Database (GDB) - The Generic Data Base Study (GDB): Survey of Morbidity and Mortality in High Risk Preterm InfantsThis study includes data from 18 participating NICHD Network centers on infants less than 29 weeks gestational age (401 grams to 1000 grams) for the purpose of providing data on risk factors for neonatal morbidities and consequences of neonatal disease.

GDB Follow Up Study Infants born at less than 27 weeks gestational age are assessed at 22-26 months adjusted age in terms of motor, cognitive and language skills, behavior, growth, neurodevelopmental outcome, mortality and prevalence of medical morbidities, family stress, compliance with medical and developmental care, utilization of special support services and early intervention programs, and need for follow up to school age.

NEST-A Multi-center Randomized Trial of Laparotomy vs. Drainage as the Initial Surgical Therapy for Extremely Low Birth Weight (ELBW) Infants with Necrotizing Enterocolitis (NEC) or Isolated Intestinal Perforation (IP): Outcomes at 18-22 months Adjusted AgeOutcomes at 18-22 months Adjusted Age This study will assess, whether the initial surgical treatment of ELBW infants who have NEC or IP should be a laparotomy or percutaneous drain.

Evaluation of Systemic Hypothermia Initiated After 6 Hours of Age in Infants ≥ 36 Weeks Gestation with Hypoxic-Ischemic Encephalopathy: A Bayesian Evaluation The purpose of this study is to evaluate whether induced hypothermia with body cooling initiated between 6 and 24 hours of age and continued for 96 hours in infants 36 weeks or greater gestational age with hypoxic-ischemia encephalopathy will reduce the incidence of death or disability at 18 months of age.

Hydrocortisone for Extubation (A Randomized Controlled Trial of the Effect of Hydrocortisone on Survival without Bronchopulmonary Dysplasia and on Neurodevelopmental Outcomes at 22-26 Months of Age in Intubated Infants Less than 30 Weeks Gestational Age) A randomized, placebo controlled, trial to study the efficacy and safety of a 10‐day tapering course of hydrocortisone treatment for infants less than 30 weeks estimated gestational age at birth who remain intubated at 14 ‐ 28 days postnatal age.

ALPS (Antenatal Late Preterm Steroids) secondary study We will be recruiting babies born between 340 and 356 weeks gestation to mothers who are enrolled in the NIH Maternal Fetal Medicine Units Antenatal Late Preterm Steroid study. The purpose of the study is to evaluate if antenatal corticosteroids accelerate neurophysiologic indices of brain maturation among infants born between 340 to 356 weeks gestational age as determined by aEEG.

Pharmacokinetics of Understudied Drugs Administered to Children per Standard of Care This is a Pediatric Trials Network multi-center trial will enroll babies and children to age 20. Pharmacokinetics, pharmacodynamics, influence of genetic factors, metabolic and protein profiles on therapeutics of specific understudied drugs will be studied.

ELGAN 2 The ELGAN 2 (Extremely Low Gestational Age Newborns) study is evaluating the relationship between early biomarkers (placental characteristics and blood proteins) and neurologic, neurocognitive and neurobehavioral dysfunction and brain structural abnormalities at approximately 9 years of age in infants born less than 28 weeks gestation.

Molecular Mechanisms Associated with Immune Maturation in Infants This is a collaborative project with Dr. Kristina Abel (UNC-CH Microbiology and Immunology Department) to define molecular mechanisms associated with immune development in preterm and full term infants through analyses of blood and saliva samples during the first year of life.

Transfusion of Prematures Trial: Does a Liberal Red Blood Cell Transfusion Strategy Improve Neurologically-Intact Survival of Extremely-Low-Birth-Weight Infants as Compared to a Restrictive Strategy? The objective of the TOP trial is to determine whether higher hemoglobin thresholds for transfusing ELBW infants resulting in higher hemoglobin levels lead to improvement in survival and neurodevelopmental outcome at 22-26 months.

Pharmocokinetics of Sildenafil in Premature Infants is an open-label, PK and safety profile study of sildenafil in premature infants.

Other Research Projects

Accelerating Adoption of Comparative Effectiveness Research in Premature Infants This NIH-sponsored partnership between UNC and Duke University seeks to improve short and long-term outcomes in very low birth weight infants by modifying practices based on results of comparative effectiveness research.

International Research

Assessing Cognitive and Practical Changes Following the Introduction of a Neonatal Training and Newborn Program in Ghana Cognitive changes after completion of specific neonatal resuscitation and newborn training modules for skilled birth attendants (nurses, midwives, physicians and nurse anesthetists) in Ghana, West Africa are assessed.

Simplified Regimens for Management of Possible Serious Bacterial Infections in Neonates and Young Infants for Use in Outpatient and Community Setting: A Multi-Centre Randomized Controlled Trial in Africa This is a multi-centre randomized control trial in Africa to establish whether a simplified antibiotic regiment is effective in the treatment of sepsis in neonates and young infants.

A Full Service Diagnostic Laboratory for a Rural Health Center, Equateur Province, Democratic Republic of Congo This pilot project involves equipping a health center in the Equateur Province with full diagnostic capabilities utilizing hand operated or solar energy powered equipment. Efficacy of Caterpillar Cereal for Complementary Feeding in the Democratic Republic of Congo The overall goal of the Caterpillar Cereal Study is to prevent malnutrition among young children in the Democratic Republic of the Congo by incorporating a caterpillar-based cereal into complementary feeding.